Introduction: Techniques which limit incisions, such as NOTES (Natural OrificeTranslumenal Endoscopic Surgery) or single port surgery have gained muchattention recently. They are thought to have many benefits. Someinvestigators have applied these techniques to bariatric surgery. Wehave assessed the safety of Roux-en-y gastric bypass surgery usingmicrolaparoscopy techniques as an alternative.

Methods: Retrospective analysis of institutional NSQIP (National Surgery QualityImprovement Program) data of two bariatric surgeons, one usingmicrolaparoscopy (group 1) the other using standard techniques (group2).We define microlaparoscopy as gastric bypass performed using three 3 mmtrocars and one 12mm trocar. The standard procedure was performed usingtwo 12mm trocars and two 5mm trocars. The NSQIP data was analyzed fordemographics, risk factors and outcomes variables.

Results: The surgeons performed 170 and 220 cases over a 19 month period forgroup 1 and 2 repsectively. There was no statistical difference in age,male/female distribution, average BMI, ASA class and risk factorsbetween the two groups. All cases were completed without conversion. None of themicrolaparoscopic cases had to be upgraded in trocar size. There was nostatistical difference between the two methods in mortality (0% each),return to OR within 30 days (1.8% vs. 0.9%) and postoperativeoccurrences (4.7% vs. 2.3%).

Conclusion: We conclude that microlaparoscopic gastric bypass is as safe astraditional laparoscopic gastric byass. Further randomized studies arewarranted to fully compare both methods both from a clinical and costpoint of view.